¶ … Health Literacy CRITIQUE OF CONCEPT ANALYSIS (HEALTH LITERACY)

Significance of Concept to Presenter

Health literacy is very important to me because the concept is vital when it comes to health care in general specifically in nursing. It has a great impact on the patient's capability to understand and process information necessary for optimal health. As a nurse, it is important to me that I am aware of my patient's literacy level for me to render care suitable for that patient because I am aware of the importance and the direct influence that health literacy has on the patients' health status and experience. The ability for the patient to understand the information I provide is vital to their health outcome and well-being. Asking the patient about their educational level happens to be one of the admission questions that we ask while completing admission database. In addition, health literacy has an influence on the patient's self-care ability especially when it comes to managing chronic conditions. It is crucial in prescriptions, diagnosis, monitoring, evaluation, and assessment of the status of health at any level. Therefore, health literacy plays a critical role in decision-making and management of the patient. Health literacy makes work easier; it helps me to provide my service effectively. If the patient is acquainted with some knowledge about their health, this process will be the easiest for me. In fact, delivery of the best service will not be an option but a reality.

Significance of Concept to profession

Health literacy is also fundamental to the profession of nursing because majority of the care we provide to the patient is through education. So, we ourselves need to be health literate in order to provide our patients' with accurate information. As obligated by the nursing ethics and professionalism, we are expected to communicate with clarity and purpose to the patient in order to address their needs at hand. Moreover, health literacy will enable nurses to acquire, understand, and inculcate the information needed to promote health. Health literacy plays a key role in promoting the delivery of service and thereby ensures safety and well-being of our patients at any point in the field of nursing. In healthcare, it is important that the patient understands the treatment prescribed in its entirety, towards better health outcomes.

b. Purpose of Analysis

The purpose of this analysis is to show how imperative health literacy is in the over all health status of the patient. It promotes effectiveness and reliability of the services offered. For health literacy to be effective, nurses have to be cognizant of the language and the educational level of the patient. For example, it is unrealistic to expect a patient with grade 3 health education level to understand college level instructions. Understanding this important issue would help nurses provide patients with information in a language that would promote compliance level and overall health outcome.

III. History

a. History of concept in nursing.

The history of health literacy can be traced back to the time of shift from the oral culture to the written culture practiced by the early Egyptians and Greeks (Murray, 2000). The term 'health literacy' was used for the first time in a paper in 1974 addressing the need to introduce health education in schools in the U.S.A. Amongst the first to identify health literacy and pursue it academically as regards the patients' inadequacy to understand health related documentation were Leonard and Cecelia Doak and Jane Root in the eighties. Health literacy as a concept has since evolved and gained importance. In the 1980s and 1990s, many efforts were put into trying to establish literacy skills in the health sector. Various studies conducted proved that there was a difficulty among the patients to comprehend the health education materials. These research studies made use of traditional measures of literacy like word recognition and comprehension. No research took up health literacy as a unique matter that deserved more in-depth research and analysis. The widely accepted TOFHLA (Test of Functional Health Literacy in Adults) was devised for a two-year seminal study funded by the Robert Wood Johnson Foundation only in 1992. This innovative step was followed by AMA's (American Medical Association) initiative to explore and investigate different facets of health education and literacy in 1997. Even now, scholarly work is rare on health literacy addressing the needs of those in nursing, though the correspondence between reading ability and health literacy is explored frequently (Miller & Bodie, 1994; Brez & Taylor, 1997; Fisher, 1999; French & Larrabee, 1999).

Presenter's beliefs about the concept

Before reading this literature, the concept of health...

I believed that just like academic illiteracy; health literacy could be managed through normal programs of education. I had presumed that health literacy is all about lack of knowledge but I was not aware that it has defined characteristics or tools that could measure it. I already had an understanding of its importance in achieving optimal health outcome. Reading this article made my understanding clearer because of the characteristics and different scenarios provided by the author.
b. Thoughts about author's definitions.

The definitions of health literacy by the author have brought out the comprehension, understanding and application of health literacy. I can say that I agree with these definitions since they are in line with my understanding. The author used wide range of applications to define the concept of health literacy. The diverse use of sources related to the definition shows the commitment by the author to ensure that the audience could appreciate the broad nature of health literacy. I am impressed by how the author has explored on the practicality of this issue in the society today and builds a definition that captures all the practical aspects of the concept. However, I am a bit skeptical about the author's knowledge in this concept because no further explanations were given beyond the quoted definitions. I was expecting the author to explain the definitions given by AMA, WHO, or Health 2010 further. This would have helped me as a nurse and other readers in appreciating the wider scope and the importance of the concept. Nonetheless, the value of the concept analysis as undertaken is commendable.

c. Use of the concept in at least two other disciplines.

Other fields where literacy is defined, though with slight difference are Education and Psychology. In education, literacy is a very essential tool. It is as necessary in academics as it is in nursing and health. Academic education cannot be realized without meeting the elements of literacy. In Education, one definition of literacy is "use printed and written information to function in Society, to achieve one's goals, and to develop one's knowledge and potential" (Henkelman, 2010). Even though this definition is from education, the same concept still applies. The end result and the goal are still knowledge development and attainment.

Another definition of literacy that I found relevant pertains to psychology where literacy is defined as "knowledge and beliefs about mental disorders which aid their recognition, management or prevention" (Jorm, 2011). The definition here is unique, short and broad. To me the definition here is somewhat different as it uses the words 'recognition', 'management', and 'prevention'. But effectively, it corresponds to ones ability to understand and be able to make an informed decision. In this field (psychology), not much is talked about the "Numeracy skills"

. As in nursing, literacy is still a hindrance to many practitioners in the field of psychology. The practitioners face difficulty in passing on relevant and useful information to their patients that lack adequate literacy levels. In both these fields, education and psychology, as in nursing, the underlying feature to successfully transfer knowledge and gain positive outcome is literacy. Specific information towards betterment in any of the mentioned fields can be transferred and received only through adequate literacy.

III. Definitions

A. State five definitions of the concept.

From the article, three definitions of health literacy were used. I wish it could have been more in order to better understand the concept. The definition by AMA as given in the article refers to "a constellation of skills, including the ability to perform basic reading and numerical tasks required to function in the health care environment" (Speros, 2005). The inherent meaning of this definition is the ability to use the acquired skills to read, write, and work on numerical matters related to health and its activities.

In the article, Healthy People 2010, the definition of literacy is "the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions" (Speros, 2005). The U.S. Federal government is shown to have liked this definition of literacy. The essential features of this definition are that it requires participants to use advanced level of thinking to make informed decisions as it relates to health.

Another definition of the concept is captured from the World Health Organization, defining it as, "Health literacy represents the cognitive and social skills, which determine the motivation and ability of individuals to gain access to, understand, and use information in ways…